BACKGROUND Cancer care faces challenges due to tumor heterogeneity and rapidly evolving therapies,necessitating artificial intelligence(AI)-driven clinical decision support.While general-purpose models like ChatGPT of...BACKGROUND Cancer care faces challenges due to tumor heterogeneity and rapidly evolving therapies,necessitating artificial intelligence(AI)-driven clinical decision support.While general-purpose models like ChatGPT offer adaptability,domain-specific systems(e.g.,DeepSeek)may better align with clinical guidelines.However,their comparative efficacy in oncology remains underexplored.This study hypothesizes that domain-specific AI will outperform general-purpose models in technical accuracy,while the latter will excel in patient-centered communication.AIMS To compare ChatGPT and DeepSeek in oncology decision support for diagnosis,treatment,and patient communication.METHODS A retrospective analysis was conducted using 1200 anonymized oncology cases(2018–2023)from The Cancer Genome Atlas and institutional databases,covering six cancer types.Each case included histopathology,imaging,genomic profiles,and treatment histories.Both models generated diagnostic interpretations,staging assessments,and therapy recommendations.Performance was evaluated against NCCN/ESMO guidelines and expert oncologist panels using F1-scores,Cohen'sκ,Likert-scale ratings,and readability metrics.Statistical significance was assessed via analysis of variance and post-hoc Tukey tests.RESULTS DeepSeek demonstrated superior performance in diagnostic accuracy(F1-score:89.2%vs ChatGPT's 76.5%,P<0.001)and treatment alignment with guidelines(κ=0.82 vs 0.67,P=0.003).ChatGPT exhibited strengths in patient communi-cation,generating layman-friendly explanations(readability score:8.2/10 vs DeepSeek's 6.5/10,P=0.012).Both models showed limitations in rare cancer subtypes(e.g.,cholangiocarcinoma),with accuracy dropping below 60%.Clinicians rated DeepSeek's outputs as more actionable(4.3/5 vs 3.7/5,P=0.021)but highlighted ChatGPT's utility in palliative care discussions.CONCLUSION Domain-specific AI(DeepSeek)excels in technical precision,while general-purpose models(ChatGPT)enhance patient engagement.A hybrid system integrating both approaches may optimize oncology workflows,contingent on expanded training for rare cancers and real-time guideline updates.展开更多
PM_(2.5)and O_(3) are two major issues hindering air quality improvement in China.However,the response of these two pollutants to anthropogenic emission variations in the real atmosphere was not yet well understood.He...PM_(2.5)and O_(3) are two major issues hindering air quality improvement in China.However,the response of these two pollutants to anthropogenic emission variations in the real atmosphere was not yet well understood.Here,we selected the short-term epidemic lockdown in Wuhu in 2022 as a case study and evaluated the impacts of meteorology and anthropogenic emission on PM_(2.5)and O_(3) using field observations combined with machine learning algorithms.The results showed that NO_(2) observed during the lockdown was 32.2±8.1μg/m^(3),10.1%lower than before the lockdown,and that NO_(2) continued to decrease by 19.2%after the lockdown.Notably,both PM_(2.5)and O_(3) concentrations were higher during the lockdown than before and after the lockdown.Random forest model revealed that meteorological conditions during the lockdown increased PM_(2.5)and O_(3) by 8.7%and 24.2%,respectively,but decreased NO_(2) by 6.4%.Atmospheric pressure and relative humidity were the main meteorological variables influencing PM_(2.5)and O_(3) variations,respectively.Scenario simulation analysis uncovered that anthropogenic emission reduction caused by the lockdown reduced NO_(2) by 19.7%,but increased PM_(2.5)and O_(3) by 6.3%and 26.8%,respectively.This was mainly due to the weakening titration effect of nitrogen oxides and enhanced atmospheric oxidation capacity,further increasing O_(3) and secondary PM_(2.5)production.Our results revealed that NO_(2) in Wuhu decreased significantly due to short-term epidemic lockdown,but PM_(2.5)and O_(3) pollution were not effectively reduced.To continuously improve future urban air quality,joint reductions in emissions from multiple anthropogenic sources and multiple pollutants are required.展开更多
This study used the marginal likelihood and Bayesian posterior model probability for evaluation of model complexity in order to avoid using over-complex models for numerical simulations. It focused on investigation of...This study used the marginal likelihood and Bayesian posterior model probability for evaluation of model complexity in order to avoid using over-complex models for numerical simulations. It focused on investigation of the impacts of prior parameter distributions(involved in calculating the marginal likelihood) on the evaluation of model complexity. We argue that prior parameter distributions should define the parameter space in which numerical simulations are made. New perspectives on the prior parameter distribution and posterior model probability were demonstrated in an example of groundwater solute transport modeling with four models, each simulating four column experiments. The models had different levels of complexity in terms of their model structures and numbers of calibrated parameters. The posterior model probability was evaluated for four cases with different prior parameter distributions. While the distributions substantially impacted model ranking, the model ranking in each case was reasonable for the specific circumstances in which numerical simulations were made. For evaluation of model complexity, it is thus necessary to determine the parameter spaces for modeling, which can be done by conducting numerical simulation and usineg engineering judgment based on understanding of the system being studied.展开更多
Introduction:Transposition of the great arteries(TGA)with aortopulmonary window is a rare type of congenital heart disease with limited experience.We reported a neonate aged 25 days receiving the arterial switch opera...Introduction:Transposition of the great arteries(TGA)with aortopulmonary window is a rare type of congenital heart disease with limited experience.We reported a neonate aged 25 days receiving the arterial switch operation and assisted with extracorporeal membrane oxygenation.Conclusion:TGA with aortopulmonary window can be safely correctly with the arterial switch operation.展开更多
Background Hypoxemia sometimes occurs in the emergency room in the patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）, even in those with administration of conventional ...Background Hypoxemia sometimes occurs in the emergency room in the patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）, even in those with administration of conventional high-flow oxygen inhalation. The objective of the present study was to evaluate the effectiveness of non-invasive ventilation （NIV） in improving blood oxygen content and hemorheology in patients with AMI and hypoxemia. Methods This prospective study enrolled 50 consecutive eligible patients with AMI （aged 72.3 ± 9.5 years）, who had undergone PCI and been administered high-flow oxygen but still had hypoxemia. Blood was taken before NIV and at 0.5, 1, and 2 h after NIV. Blood gases, hemorheological variables including erythrocyte deformability, erythrocyte aggregation, erythrocyte osmotic fragility, membrane fluidity, and oxidative stress level were measured. Results Blood PaO2 increased to normal by 1 h after NIV. Assessed hemorheological variables had all improved and plasma malondialdehyde concentration decreased significantly after 2 h of NIV. Conclusions Our data suggest that NIV can help to improve blood oxygen content, hemorheological status, and minimize plasma lipid peroxidation injury in hypoxemic patients with AMI who have undergone PCI.展开更多
AIM:To assess the anti-cancer effect of lobaplatin on human gastric cancer cells,and to explore the underlying molecular mechanisms.METHODS:The human gastric cancer cell lines MKN-28,AGS and MKN-45 were used.The cytot...AIM:To assess the anti-cancer effect of lobaplatin on human gastric cancer cells,and to explore the underlying molecular mechanisms.METHODS:The human gastric cancer cell lines MKN-28,AGS and MKN-45 were used.The cytotoxicity of lobaplatin was detected using an MTS cell proliferation assay.Flow cytometry was used to detect cell apoptosis using Annexin V-FITC Apoptosis Detection Kit.The expression of apoptosis-regulated genes was examined at the protein level using Western blot.RESULTS:Lobaplatin inhibited the proliferation of human gastric cancer cells and induced apoptosis,which may be associated with the up-regulation of Bax expression,poly(ADP-ribose)polymerase(PARP)cleavage,p53 expression and the reduction of Bcl-2 expression.CONCLUSION:The cytotoxicity of lobaplatin may be due to its ability of inducing apoptosis of gastric cancer cells,which would support the potential use of lobaplatin for the therapy of gastric cancer.展开更多
The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the result...The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the results of multi-center clinical nutrition research for congenital heart disease following thefirst Chinese consensus edition of 2016.The consensus was also shaped by the results of three discussion sessions and two questionnaires con-ducted by the 13-member collaboration group.This process was informed by both clinical guidelines and expert consensus.The quality of literature,both in English and Chinese,and the level of recommendations were evaluated using the Grading of Recommendations Assessment,Development,and Evaluations(GRADE)system.展开更多
The phenomenon of secondary electron emission is of considerable interest in areas such as particle accelerators and on-board radio frequency(RF) components.Total secondary electron yield(TSEY) is a parameter that is ...The phenomenon of secondary electron emission is of considerable interest in areas such as particle accelerators and on-board radio frequency(RF) components.Total secondary electron yield(TSEY) is a parameter that is frequently used to describe the secondary electron emission capability of a material.It has been widely recognized that the TSEY vs.primary electron energy curve has a single-hump shape.However, the TSEY–energy curve with a double-hump shape was also observed experimentally-this anomaly still lacks explanation.In this work, we explain this anomaly with the help of a millimetre-scale(mm-scale) silver pillar array fabricated by three-dimensional(3 D) printing technology.The TSEY–energy curve of this pillar array as well as its flat counterpart is obtained using sample current method.The measurement results show that for the considered primary electron energy(40–1500 eV), the pillar array can obviously suppress TSEY,and its TSEY–energy curve has an obvious double-hump shape.Through Monte Carlo simulations and electron beam spot size measurements, we successfully attribute the double-hump effect to the dependence of electron beam spot size on the primary electron energy.The observations of this work may be of help in determining the TSEY of roughened surface with characteristic surface structures comparable to electron beam spot size.It also experimentally confirms the TSEY suppression effect of pillar arrays.展开更多
Human exposures to pesticides can occur in the workplace,in the household and through the ambient environment.While several articles have reviewed the impact of pesticide exposures on human respiratory health in occup...Human exposures to pesticides can occur in the workplace,in the household and through the ambient environment.While several articles have reviewed the impact of pesticide exposures on human respiratory health in occupational settings,to the best of our knowledge,this article is the first one to review published studies on the association between pesticide exposures and human respiratory health in the general populations.In this article,we critically reviewed evidences up to date studying the associations between non-occupational pesticide exposures and respiratory health in general populations.This article also highlighted questions arising from these studies,including our recent analyses using the data from the Canadian Health Measures Survey（CHMS）,for future research.We found few studies have addressed the impact of environmental pesticide exposures on respiratory health,especially on lung function,in general populations.In the studies using the data from CHMS Cycle 1,exposures to OP insecticides,pyrethroid insecticides,and the organochlorine pesticide DDT were associated with impaired lung function in the Canadian general population,but no significant associations were observed for the herbicide 2,4-D.Future research should focus on the potential age-specific and pesticide-specific effect on respiratory health in the general population,and repeated longitudinal study design is critical for assessing the temporal variations in pesticide exposures.Research findings from current studies of non-occupational pesticide exposures and their health impact in general population will help to improve the role of regulatory policies in mitigating pesticide-related public health problems,and thereafter providing greater benefit to the general population.展开更多
BACKGROUND Anti-glomerular basement membrane(GBM)disease is a rare autoimmune disease manifesting as acute progressive nephritis syndrome with or without varying degrees of pulmonary hemorrhage.Anti-GBM disease coexis...BACKGROUND Anti-glomerular basement membrane(GBM)disease is a rare autoimmune disease manifesting as acute progressive nephritis syndrome with or without varying degrees of pulmonary hemorrhage.Anti-GBM disease coexisting with Immunoglobulin A(IgA)nephropathy is rarer and has different clinical manifestations and prognoses than simple anti-GBM disease.We describe a case of coexistence of these two diseases.CASE SUMMARY A 49-year-old man with hematuria and proteinuria accompanied by a slight elevation of serum creatinine was admitted to our hospital.The pathological results of renal biopsy and the elevated serum anti-GBM antibody titer supported a diagnosis of anti-GBM disease combined with IgA nephropathy.After treatment with corticosteroids and cyclophosphamide,the patient's serum creatinine was relatively stable,and the hematuria and proteinuria moderately improved in the subsequent six months.CONCLUSION Anti-GBM disease coexisting with IgA nephropathy is rare.The clinical manifestations and prognosis are better than those of simple anti-GBM disease.In this case,the patient's condition was improved and his renal function remained relatively stable with corticosteroid and cyclophosphamide treatment.New detection methods to identify whether the crescents in this case were derived from anti-GBM disease or IgA nephropathy are worthy of further exploration.展开更多
Background Surgical resection of the lesions remains the main treatment method for most symptomatic spinal cord cavernous malformations(SCCMs)to eliminate the occupation and associated subsequent lifelong haemorrhagic...Background Surgical resection of the lesions remains the main treatment method for most symptomatic spinal cord cavernous malformations(SCCMs)to eliminate the occupation and associated subsequent lifelong haemorrhagic risk.However,the timing of surgical intervention remains controversial,especially for patients in the acute stage after severe haemorrhage.Methods Patients diagnosed with SCCMs who were surgically treated between January 2002 and December 2021 were selected and retrospectively reviewed.The Modified McCormick Scale(MMS)was used to evaluate neurological and disability status.All medical information was reviewed,and all patients were followed up for at least 6 months.Results A total of 279 patients were ultimately included.With regard to long-term outcomes,110(39.4%)patients improved,159(57.0%)remained unchanged and 10(3.6%)worsened.For patients with an MMS score of 2–5 on admission,in univariate and multivariate analyses,a≤6 weeks period between onset and surgery(adjusted OR 3.211,95%CI 1.504 to 6.856,p=0.003)was a significant predictor of improved MMS.Among 69 patients who first presented with severe haemorrhage,undergoing surgery within 6 weeks of the onset of severe haemorrhage(adjusted OR 4.901,95%CI 1.126 to 21.325,p=0.034)was significantly associated with improvement of MMS score.Conclusion Surgical timing can influence the long-term outcome of SCCMs.For patients with symptomatic SCCMs,especially those with severe haemorrhage,early surgical intervention within 6 weeks can provide more benefit.展开更多
Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is the cornerstone of acute myocardial infarction(AMI)management,both invasive and conservative.[1,2]This dual strategy improved ischemic outcomes but was o...Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is the cornerstone of acute myocardial infarction(AMI)management,both invasive and conservative.[1,2]This dual strategy improved ischemic outcomes but was offset by an increased bleeding risk.The prognostic importance of bleeding events has been well established over the past decades,as several studies have shown a strong association between bleeding and mortality.[3]The CRUSADE score is superior to other scores in predicting in-hospital major bleeding events.In this regard,in its non-ST elevation acute coronary syndromes(NSTE-ACS)guidelines,the European Society of Cardiology(ESC)stated that the CRUSADE score could be considered for bleeding risk quantification of coronary angiography in NSTE-ACS patients(class IIb,level B evidence).[4]However,the most common site of spontaneous.展开更多
Background:Congenital heart disease(CHD)is a leading cause of birth defect-related mortality.However,more recent CHD mortality data for China are lacking.Additionally,limited studies have evaluated sex,rural-urban,and...Background:Congenital heart disease(CHD)is a leading cause of birth defect-related mortality.However,more recent CHD mortality data for China are lacking.Additionally,limited studies have evaluated sex,rural-urban,and region-specific disparities of CHD mortality in China.Methods:We designed a population-based study using data from the Dataset of National Mortality Surveillance in China between 2008 and 2021.We calculated age-adjusted CHD mortality using the sixth census data of China in 2010 as the standard population.We assessed the temporal trends in CHD mortality by age,sex,area,and region from 2008 to 2021 using the joinpoint regression model.Results:From 2008 to 2021,33,534 deaths were attributed to CHD.The period witnessed a two-fold decrease in the age-adjusted CHD mortality from 1.61 to 0.76 per 100,000 persons(average annual percent change[AAPC]=-5.90%).Females tended to have lower age-adjusted CHD mortality than males,but with a similar decline rate from 2008 to 2021(females:AAPC=-6.15%;males:AAPC=-5.84%).Similar AAPC values were observed among people living in urban(AAPC=-6.64%)and rural(AAPC=-6.12%)areas.Eastern regions experienced a more pronounced decrease in the age-adjusted CHD mortality(AAPC=-7.86%)than central(AAPC=-5.83%)and western regions(AAPC=-3.71%)between 2008 and 2021.Approximately half of the deaths(46.19%)due to CHD occurred during infancy.The CHD mortality rates in 2021 were lower than those in 2008 for people aged 0-39 years,with the largest decrease observed among children aged 1-4 years(AAPC=-8.26%),followed by infants(AAPC=-7.01%).Conclusions:CHD mortality in China has dramatically decreased from 2008 to 2021.The slower decrease in CHD mortality in the central and western regions than in the eastern regions suggested that public health policymakers should pay more attention to health resources and health education for central and western regions.展开更多
Background Compared with dural arteriovenous fistulas(DAVFs)in adult,paediatric DAVFs are notable for distinct clinical manifestations,low cure rate and poor prognosis.However,due to the limitations of small sample si...Background Compared with dural arteriovenous fistulas(DAVFs)in adult,paediatric DAVFs are notable for distinct clinical manifestations,low cure rate and poor prognosis.However,due to the limitations of small sample sizes,the long-term prognosis and follow-up data have not been described.Methods Clinical data from 43 consecutive paediatric DAVFs were documented and analysed between 2002 and 2022 at the author’s institution.They were divided into infantile(Lasjaunias classification)and non-infantile(adult type and dural sinus malformation(DSM))type DAVFs based on prognosis differences.Results Their mean age at first symptoms was 8.4±6.0 years.29 boys and 14 girls presented between at birth and 18 years of age.5 of 10 patients≤1 year of age presented with asymptomatic cardiomegaly compared with 5/33 patients>1 year of age(p=0.022).42(88.4%)patients received endovascular treatment alone,while 9.3%underwent radiosurgery,burr hole embolisation or surgery.28(65.1%)patients experienced DAVF obliteration by the end of treatment.Among them,26 cases underwent embolisation alone,one case had embolisation in conjunction with surgery,and one case underwent burr hole embolisation.The overall complication rate among patients was 9.3%,all resulting from endovascular treatment.According to the Lasjaunias Classification,there were 18 cases of adult type,17 cases of infantile type and 8 cases of DSM.Compared with non-infantile type DAVFs,infantile-type DAVFs showed more times of treatment,lower cure rate and worse prognosis(p<0.001,0.003 and 0.021,respectively).The average follow-up duration was 41.4±36.2 months(3-228 months).8(22.9%)patients died.Conclusions Most adult-type DAVFs and DSMs can now be effectively treated with embolisation,resulting in good outcomes and prognosis.However,there are still challenges in treating infantile-type DAVFs,and the prognosis is frequently poor.展开更多
文摘BACKGROUND Cancer care faces challenges due to tumor heterogeneity and rapidly evolving therapies,necessitating artificial intelligence(AI)-driven clinical decision support.While general-purpose models like ChatGPT offer adaptability,domain-specific systems(e.g.,DeepSeek)may better align with clinical guidelines.However,their comparative efficacy in oncology remains underexplored.This study hypothesizes that domain-specific AI will outperform general-purpose models in technical accuracy,while the latter will excel in patient-centered communication.AIMS To compare ChatGPT and DeepSeek in oncology decision support for diagnosis,treatment,and patient communication.METHODS A retrospective analysis was conducted using 1200 anonymized oncology cases(2018–2023)from The Cancer Genome Atlas and institutional databases,covering six cancer types.Each case included histopathology,imaging,genomic profiles,and treatment histories.Both models generated diagnostic interpretations,staging assessments,and therapy recommendations.Performance was evaluated against NCCN/ESMO guidelines and expert oncologist panels using F1-scores,Cohen'sκ,Likert-scale ratings,and readability metrics.Statistical significance was assessed via analysis of variance and post-hoc Tukey tests.RESULTS DeepSeek demonstrated superior performance in diagnostic accuracy(F1-score:89.2%vs ChatGPT's 76.5%,P<0.001)and treatment alignment with guidelines(κ=0.82 vs 0.67,P=0.003).ChatGPT exhibited strengths in patient communi-cation,generating layman-friendly explanations(readability score:8.2/10 vs DeepSeek's 6.5/10,P=0.012).Both models showed limitations in rare cancer subtypes(e.g.,cholangiocarcinoma),with accuracy dropping below 60%.Clinicians rated DeepSeek's outputs as more actionable(4.3/5 vs 3.7/5,P=0.021)but highlighted ChatGPT's utility in palliative care discussions.CONCLUSION Domain-specific AI(DeepSeek)excels in technical precision,while general-purpose models(ChatGPT)enhance patient engagement.A hybrid system integrating both approaches may optimize oncology workflows,contingent on expanded training for rare cancers and real-time guideline updates.
基金supported by the National Natural Science Foundation of China(No.42207128)the Key Research Projects of Natural Science in Colleges and Universities of Anhui Province(No.KJ2021A0091)the Natural Science Foundation of Anhui Province(No.2008085MD111)。
文摘PM_(2.5)and O_(3) are two major issues hindering air quality improvement in China.However,the response of these two pollutants to anthropogenic emission variations in the real atmosphere was not yet well understood.Here,we selected the short-term epidemic lockdown in Wuhu in 2022 as a case study and evaluated the impacts of meteorology and anthropogenic emission on PM_(2.5)and O_(3) using field observations combined with machine learning algorithms.The results showed that NO_(2) observed during the lockdown was 32.2±8.1μg/m^(3),10.1%lower than before the lockdown,and that NO_(2) continued to decrease by 19.2%after the lockdown.Notably,both PM_(2.5)and O_(3) concentrations were higher during the lockdown than before and after the lockdown.Random forest model revealed that meteorological conditions during the lockdown increased PM_(2.5)and O_(3) by 8.7%and 24.2%,respectively,but decreased NO_(2) by 6.4%.Atmospheric pressure and relative humidity were the main meteorological variables influencing PM_(2.5)and O_(3) variations,respectively.Scenario simulation analysis uncovered that anthropogenic emission reduction caused by the lockdown reduced NO_(2) by 19.7%,but increased PM_(2.5)and O_(3) by 6.3%and 26.8%,respectively.This was mainly due to the weakening titration effect of nitrogen oxides and enhanced atmospheric oxidation capacity,further increasing O_(3) and secondary PM_(2.5)production.Our results revealed that NO_(2) in Wuhu decreased significantly due to short-term epidemic lockdown,but PM_(2.5)and O_(3) pollution were not effectively reduced.To continuously improve future urban air quality,joint reductions in emissions from multiple anthropogenic sources and multiple pollutants are required.
基金supported by the U.S.Department of Energy Early Career Research Program Award(Grant No.DE-SC0008272)U.S.National Science Foundation(Grant No.1552329)
文摘This study used the marginal likelihood and Bayesian posterior model probability for evaluation of model complexity in order to avoid using over-complex models for numerical simulations. It focused on investigation of the impacts of prior parameter distributions(involved in calculating the marginal likelihood) on the evaluation of model complexity. We argue that prior parameter distributions should define the parameter space in which numerical simulations are made. New perspectives on the prior parameter distribution and posterior model probability were demonstrated in an example of groundwater solute transport modeling with four models, each simulating four column experiments. The models had different levels of complexity in terms of their model structures and numbers of calibrated parameters. The posterior model probability was evaluated for four cases with different prior parameter distributions. While the distributions substantially impacted model ranking, the model ranking in each case was reasonable for the specific circumstances in which numerical simulations were made. For evaluation of model complexity, it is thus necessary to determine the parameter spaces for modeling, which can be done by conducting numerical simulation and usineg engineering judgment based on understanding of the system being studied.
文摘Introduction:Transposition of the great arteries(TGA)with aortopulmonary window is a rare type of congenital heart disease with limited experience.We reported a neonate aged 25 days receiving the arterial switch operation and assisted with extracorporeal membrane oxygenation.Conclusion:TGA with aortopulmonary window can be safely correctly with the arterial switch operation.
文摘Background Hypoxemia sometimes occurs in the emergency room in the patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）, even in those with administration of conventional high-flow oxygen inhalation. The objective of the present study was to evaluate the effectiveness of non-invasive ventilation （NIV） in improving blood oxygen content and hemorheology in patients with AMI and hypoxemia. Methods This prospective study enrolled 50 consecutive eligible patients with AMI （aged 72.3 ± 9.5 years）, who had undergone PCI and been administered high-flow oxygen but still had hypoxemia. Blood was taken before NIV and at 0.5, 1, and 2 h after NIV. Blood gases, hemorheological variables including erythrocyte deformability, erythrocyte aggregation, erythrocyte osmotic fragility, membrane fluidity, and oxidative stress level were measured. Results Blood PaO2 increased to normal by 1 h after NIV. Assessed hemorheological variables had all improved and plasma malondialdehyde concentration decreased significantly after 2 h of NIV. Conclusions Our data suggest that NIV can help to improve blood oxygen content, hemorheological status, and minimize plasma lipid peroxidation injury in hypoxemic patients with AMI who have undergone PCI.
基金Supported by National Natural Science Foundation of China,No.81101648
文摘AIM:To assess the anti-cancer effect of lobaplatin on human gastric cancer cells,and to explore the underlying molecular mechanisms.METHODS:The human gastric cancer cell lines MKN-28,AGS and MKN-45 were used.The cytotoxicity of lobaplatin was detected using an MTS cell proliferation assay.Flow cytometry was used to detect cell apoptosis using Annexin V-FITC Apoptosis Detection Kit.The expression of apoptosis-regulated genes was examined at the protein level using Western blot.RESULTS:Lobaplatin inhibited the proliferation of human gastric cancer cells and induced apoptosis,which may be associated with the up-regulation of Bax expression,poly(ADP-ribose)polymerase(PARP)cleavage,p53 expression and the reduction of Bcl-2 expression.CONCLUSION:The cytotoxicity of lobaplatin may be due to its ability of inducing apoptosis of gastric cancer cells,which would support the potential use of lobaplatin for the therapy of gastric cancer.
基金supported by the National Natural Science Foundation of China(81970265,82270310)a Sub-Project of the National Key R&D Program“The recognition and Identification of Genetic Pathogenic Genes for Structural Birth Defects”(2021YFC2701002)+1 种基金Nanjing Science and Technology Development Project(2019060007)Jiangsu Provincial Key Research and Development Program(BE2023662).
文摘The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the results of multi-center clinical nutrition research for congenital heart disease following thefirst Chinese consensus edition of 2016.The consensus was also shaped by the results of three discussion sessions and two questionnaires con-ducted by the 13-member collaboration group.This process was informed by both clinical guidelines and expert consensus.The quality of literature,both in English and Chinese,and the level of recommendations were evaluated using the Grading of Recommendations Assessment,Development,and Evaluations(GRADE)system.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.U1832190,61501364,U1537211,and 11705142)
文摘The phenomenon of secondary electron emission is of considerable interest in areas such as particle accelerators and on-board radio frequency(RF) components.Total secondary electron yield(TSEY) is a parameter that is frequently used to describe the secondary electron emission capability of a material.It has been widely recognized that the TSEY vs.primary electron energy curve has a single-hump shape.However, the TSEY–energy curve with a double-hump shape was also observed experimentally-this anomaly still lacks explanation.In this work, we explain this anomaly with the help of a millimetre-scale(mm-scale) silver pillar array fabricated by three-dimensional(3 D) printing technology.The TSEY–energy curve of this pillar array as well as its flat counterpart is obtained using sample current method.The measurement results show that for the considered primary electron energy(40–1500 eV), the pillar array can obviously suppress TSEY,and its TSEY–energy curve has an obvious double-hump shape.Through Monte Carlo simulations and electron beam spot size measurements, we successfully attribute the double-hump effect to the dependence of electron beam spot size on the primary electron energy.The observations of this work may be of help in determining the TSEY of roughened surface with characteristic surface structures comparable to electron beam spot size.It also experimentally confirms the TSEY suppression effect of pillar arrays.
文摘Human exposures to pesticides can occur in the workplace,in the household and through the ambient environment.While several articles have reviewed the impact of pesticide exposures on human respiratory health in occupational settings,to the best of our knowledge,this article is the first one to review published studies on the association between pesticide exposures and human respiratory health in the general populations.In this article,we critically reviewed evidences up to date studying the associations between non-occupational pesticide exposures and respiratory health in general populations.This article also highlighted questions arising from these studies,including our recent analyses using the data from the Canadian Health Measures Survey（CHMS）,for future research.We found few studies have addressed the impact of environmental pesticide exposures on respiratory health,especially on lung function,in general populations.In the studies using the data from CHMS Cycle 1,exposures to OP insecticides,pyrethroid insecticides,and the organochlorine pesticide DDT were associated with impaired lung function in the Canadian general population,but no significant associations were observed for the herbicide 2,4-D.Future research should focus on the potential age-specific and pesticide-specific effect on respiratory health in the general population,and repeated longitudinal study design is critical for assessing the temporal variations in pesticide exposures.Research findings from current studies of non-occupational pesticide exposures and their health impact in general population will help to improve the role of regulatory policies in mitigating pesticide-related public health problems,and thereafter providing greater benefit to the general population.
文摘BACKGROUND Anti-glomerular basement membrane(GBM)disease is a rare autoimmune disease manifesting as acute progressive nephritis syndrome with or without varying degrees of pulmonary hemorrhage.Anti-GBM disease coexisting with Immunoglobulin A(IgA)nephropathy is rarer and has different clinical manifestations and prognoses than simple anti-GBM disease.We describe a case of coexistence of these two diseases.CASE SUMMARY A 49-year-old man with hematuria and proteinuria accompanied by a slight elevation of serum creatinine was admitted to our hospital.The pathological results of renal biopsy and the elevated serum anti-GBM antibody titer supported a diagnosis of anti-GBM disease combined with IgA nephropathy.After treatment with corticosteroids and cyclophosphamide,the patient's serum creatinine was relatively stable,and the hematuria and proteinuria moderately improved in the subsequent six months.CONCLUSION Anti-GBM disease coexisting with IgA nephropathy is rare.The clinical manifestations and prognosis are better than those of simple anti-GBM disease.In this case,the patient's condition was improved and his renal function remained relatively stable with corticosteroid and cyclophosphamide treatment.New detection methods to identify whether the crescents in this case were derived from anti-GBM disease or IgA nephropathy are worthy of further exploration.
基金supported by the National Natural Science Foundation of China(82201440,81971113,81971104)Beijing Municipal Science and Technology Commission with grant D161100003816001+1 种基金Beijing Municipal Education Commission with grant CIT&TCD201904095Beijing Municipal Administration of Hospitals with grant DFL20180801 and QML20190802.
文摘Background Surgical resection of the lesions remains the main treatment method for most symptomatic spinal cord cavernous malformations(SCCMs)to eliminate the occupation and associated subsequent lifelong haemorrhagic risk.However,the timing of surgical intervention remains controversial,especially for patients in the acute stage after severe haemorrhage.Methods Patients diagnosed with SCCMs who were surgically treated between January 2002 and December 2021 were selected and retrospectively reviewed.The Modified McCormick Scale(MMS)was used to evaluate neurological and disability status.All medical information was reviewed,and all patients were followed up for at least 6 months.Results A total of 279 patients were ultimately included.With regard to long-term outcomes,110(39.4%)patients improved,159(57.0%)remained unchanged and 10(3.6%)worsened.For patients with an MMS score of 2–5 on admission,in univariate and multivariate analyses,a≤6 weeks period between onset and surgery(adjusted OR 3.211,95%CI 1.504 to 6.856,p=0.003)was a significant predictor of improved MMS.Among 69 patients who first presented with severe haemorrhage,undergoing surgery within 6 weeks of the onset of severe haemorrhage(adjusted OR 4.901,95%CI 1.126 to 21.325,p=0.034)was significantly associated with improvement of MMS score.Conclusion Surgical timing can influence the long-term outcome of SCCMs.For patients with symptomatic SCCMs,especially those with severe haemorrhage,early surgical intervention within 6 weeks can provide more benefit.
文摘Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is the cornerstone of acute myocardial infarction(AMI)management,both invasive and conservative.[1,2]This dual strategy improved ischemic outcomes but was offset by an increased bleeding risk.The prognostic importance of bleeding events has been well established over the past decades,as several studies have shown a strong association between bleeding and mortality.[3]The CRUSADE score is superior to other scores in predicting in-hospital major bleeding events.In this regard,in its non-ST elevation acute coronary syndromes(NSTE-ACS)guidelines,the European Society of Cardiology(ESC)stated that the CRUSADE score could be considered for bleeding risk quantification of coronary angiography in NSTE-ACS patients(class IIb,level B evidence).[4]However,the most common site of spontaneous.
基金supported by grants from the National Key Research and Development Program of China(Nos.2021YFC2701004 and 2016YFC1000506)CAMS Innovation Fund for Medical Sciences(No.2019-I2M-5-002)+1 种基金Shanghai Health Commission of Health Industry Clinical Research Project(No.20234Y0211)Three-Year Planning for Strengthening the Construction of Public Health System in Shanghai(No.GWIV-24).
文摘Background:Congenital heart disease(CHD)is a leading cause of birth defect-related mortality.However,more recent CHD mortality data for China are lacking.Additionally,limited studies have evaluated sex,rural-urban,and region-specific disparities of CHD mortality in China.Methods:We designed a population-based study using data from the Dataset of National Mortality Surveillance in China between 2008 and 2021.We calculated age-adjusted CHD mortality using the sixth census data of China in 2010 as the standard population.We assessed the temporal trends in CHD mortality by age,sex,area,and region from 2008 to 2021 using the joinpoint regression model.Results:From 2008 to 2021,33,534 deaths were attributed to CHD.The period witnessed a two-fold decrease in the age-adjusted CHD mortality from 1.61 to 0.76 per 100,000 persons(average annual percent change[AAPC]=-5.90%).Females tended to have lower age-adjusted CHD mortality than males,but with a similar decline rate from 2008 to 2021(females:AAPC=-6.15%;males:AAPC=-5.84%).Similar AAPC values were observed among people living in urban(AAPC=-6.64%)and rural(AAPC=-6.12%)areas.Eastern regions experienced a more pronounced decrease in the age-adjusted CHD mortality(AAPC=-7.86%)than central(AAPC=-5.83%)and western regions(AAPC=-3.71%)between 2008 and 2021.Approximately half of the deaths(46.19%)due to CHD occurred during infancy.The CHD mortality rates in 2021 were lower than those in 2008 for people aged 0-39 years,with the largest decrease observed among children aged 1-4 years(AAPC=-8.26%),followed by infants(AAPC=-7.01%).Conclusions:CHD mortality in China has dramatically decreased from 2008 to 2021.The slower decrease in CHD mortality in the central and western regions than in the eastern regions suggested that public health policymakers should pay more attention to health resources and health education for central and western regions.
基金funded by the National Natural Science Foundation of China(No.82101460).
文摘Background Compared with dural arteriovenous fistulas(DAVFs)in adult,paediatric DAVFs are notable for distinct clinical manifestations,low cure rate and poor prognosis.However,due to the limitations of small sample sizes,the long-term prognosis and follow-up data have not been described.Methods Clinical data from 43 consecutive paediatric DAVFs were documented and analysed between 2002 and 2022 at the author’s institution.They were divided into infantile(Lasjaunias classification)and non-infantile(adult type and dural sinus malformation(DSM))type DAVFs based on prognosis differences.Results Their mean age at first symptoms was 8.4±6.0 years.29 boys and 14 girls presented between at birth and 18 years of age.5 of 10 patients≤1 year of age presented with asymptomatic cardiomegaly compared with 5/33 patients>1 year of age(p=0.022).42(88.4%)patients received endovascular treatment alone,while 9.3%underwent radiosurgery,burr hole embolisation or surgery.28(65.1%)patients experienced DAVF obliteration by the end of treatment.Among them,26 cases underwent embolisation alone,one case had embolisation in conjunction with surgery,and one case underwent burr hole embolisation.The overall complication rate among patients was 9.3%,all resulting from endovascular treatment.According to the Lasjaunias Classification,there were 18 cases of adult type,17 cases of infantile type and 8 cases of DSM.Compared with non-infantile type DAVFs,infantile-type DAVFs showed more times of treatment,lower cure rate and worse prognosis(p<0.001,0.003 and 0.021,respectively).The average follow-up duration was 41.4±36.2 months(3-228 months).8(22.9%)patients died.Conclusions Most adult-type DAVFs and DSMs can now be effectively treated with embolisation,resulting in good outcomes and prognosis.However,there are still challenges in treating infantile-type DAVFs,and the prognosis is frequently poor.
